1909.] Urine in Chronic Disease of the Pancreas. 375 



D. The aniline acetate test, when applied to the original solution,* gave a. 

 uniform bright red colour. The phloroglucin test was also positive, showing 

 a bright red colour at the boiling-point and forming a dark purple precipitate 

 after boiling for about one minute. Spectroscopical examination of a 

 solution of this precipitate in 93-per-cent. alcohol revealed an absorption 

 band in the green, to the right of D. Tollen's orcin test, and Bial's reagentf 

 gave a dull red-brown colour and formed a precipitate, but no green-tint 

 was observed. An extract of this made with four parts of amyl alcohol and 

 one part of ethyl alcohol showed, however, a dark band between C and D 

 when it was examined with the spectroscope. The solution showed no gas 

 formation or diminution of its reducing powers after being incubated with 

 brewer's yeast for 24 hours at 37° C. 



These results indicated that the fluid prepared in the manner described 

 from the urine of patients having the clinical signs and symptoms of 

 pancreatitis contained an unfermentable sugar giving the reactions of a 

 pentose. A careful examination of the urine in these cases, and also in 

 over 500 others that have given a positive " pancreatic " reaction, failed to 

 reveal any free sugar to which the reaction might be due, and it was 

 therefore evident that the pentose was not free as such in the urine, but 

 was derived from some antecedent substance in the course of the reaction. 

 Numerous attempts have been made to isolate this and determine its nature, 

 but so far without success. It does not appear to be precipitated by 

 alcohol, ether, ammonium sulphate, magnesium sulphate, lead acetate, 

 mercuric chloride, or calcium chloride. Treatment of the urine with 

 benzoyl chloride and sodium hydrate has also given negative results. 



Beside the case already mentioned, in which a detailed examination of 

 the pancreas was made, it has been possible to investigate the condition 

 of the gland after death in 26 others in which the urine had been examined 

 during life. In 9, where no reaction had been obtained, it appeared to be 

 normal both macroscopically and microscopically. In 13 there was evidence 

 of chronic inflammation : these had all given a positive reaction. Four 

 proved to be cases of cancer of the pancreas, 2 of these had given a positive 

 reaction and 2 a negative result. Of the 13 that showed chronic pancreatitis, 

 12 were of the typical interlobular type, and 1 was in an early stage of 

 inflammation with no marked increase of fibrous tissue, but an interlobular 

 and intercellular infiltration of small round cells and granular changes in 

 the acinar cells. 



The occurrence of this reaction in the urine of patients who presented the 



* Mullikin, 'Identification of Pure Organic Compounds,' 1904, p. 33. 

 t 'Deutsch. Med. Wocfa.,' 1902 and 1903. 



